Screening for Hepatitis C Is Low Among Baby Boomers

A recent study found that less than 13 percent of baby boomers were screened for the virus despite the recent approval of several effective treatments.

Almost half of liver cancer cases in the United States are caused by Hepatitis C virus (HCV) infection.

Unlike many cancers, the incidence of liver cancer is increasing in the United States. Statistics from the Surveillance, Epidemiology, and End Results (SEER) Program indicate that deaths from liver and intrahepatic bile duct cancer have been on the rise since 1975, and it is estimated that liver cancer will become the third deadliest cancer by 2030.

Even with these troubling numbers, preventative measures, such as getting screened for HCV infection, remain low in the United States.

Baby boomers have disproportionately high rates of HCV infection, as over 75 percent of HCV-positive individuals were born between 1945 and 1965. It is estimated that one in 30 baby boomers is chronically infected with HCV.

"Hepatitis C is an interesting virus because people who develop a chronic infection remain asymptomatic for decades and don’t know they’re infected," explained Monica Kasting, PhD, from the Moffitt Cancer Center and lead author of a recent study published in Cancer Epidemiology, Biomarkers & Prevention. "Most of the baby boomers who screen positive for HCV infection were infected over 30 years ago, before the virus was identified."

Even though infection with HCV is often asymptomatic, it can lead to life-threatening conditions. Many cases of liver cancer could be prevented through HCV screening and treatment.

Because baby boomers have high rates of HCV infection, both the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Tasks Force (USPTSF) recommend that this population gets screened for the virus. Nonetheless, data from 2013 found that only 12 percent of baby boomers had been screened.

Dr. Kasting and her colleagues conducted this study to determine if the recent approval of several effective treatments for chronic HCV infection by the U.S. Food and Drug Administration had influenced HCV screening rates in recent years.

The study, however, found that HCV screening in baby boomers only increased by 0.9 percent between 2013 and 2015. Moreover, the study found that less than 20 percent of baby boomers reported that their reason for screening was due to their age, despite the federal recommendations.

"Given rising rates of liver cancer and high HCV infection rates in this population, this is a critically important finding," said Anna Giuliano, PhD, from the Moffitt Cancer Center. "It shows that we have substantial room for improvement and we need additional efforts to get this population screened and treated as a strategy to reduce rising rates of liver cancer in the United States."

The researchers assessed HCV screening in four different age cohorts, and found that the screening rates were lower among women than in men in all age groups.

They also found that screening rates were lower among Hispanics and non-Hispanic Blacks born between 1945-1985. "This is concerning because these groups have higher rates of HCV infection and higher rates of advanced liver disease," noted Kasting. "This may reflect a potential health disparity in access to screening, and therefore treatment, for a highly curable infection."